Background: To find the prevalence and pattern of congenital heart diseases (CHD) at a Semi-Urban teaching hospital in Karimnagar, Andhra Pradesh, India. Methods: A thorough history, clinical examination and Trans-Thoracic-Two-Dimensional Echocardiography (TTE) was done for all the live birth, children up to 18years of age and patients between 18 to 25 years, who were referred or presented to the Department of Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Bommakal, Karimnagar (AP), over a period of 5 years from July 2008 through June 2013. Those suspected to having a CHD or referred in our department, were further evaluated with: Clinically, Twelve-Lead-Surface Electrocardiography, Chest Radiography and the diagnosis was confirmed by TTE. Trans-Thoracic-Two-Dimensional Echocardiography, M-Mode, Color flow doppler and Spectral doppler echocardiography was done in all patients in the various views. Results: Total 13,554 patients were examined and underwent TTE. Out of 13,554 patients 116 were identified as having congenital heart diseases, thus giving a prevalence of 8.55 per 1,000 live births. Isolated Ventricular septal defect (28.44%), isolated atrial septal defect (18.10%), Patent ductus arteriosus (10.34%), isolated congenital pulmonary stenosis (6.03%) and tetralogy of Fallot's (6.03%), were the commonest defects observed and confirmed by TTE. TOF was the main cyanotic CHD (6.03%), with the prevalence of 0.51% per 1,000 live births. VSD, ASD and PDA were more prevalent in males. TOF and Complete A.V. Canal defect was prevalent in females. All small size muscular and perimembranous VSD was closed spontaneously. Spontaneous closure rate of 75.00% in Muscular VSD and 52.17% in perimembranous VSD was observed. Spontaneous closure rate of Ostium secundum type ASD was 53.33%. Conclusions: The prevalence of CHD at a tertiary teaching hospital (CAIMS, Bommakal, Karimnagar, AP, India), is 8.55 per 1,000 live births. VSD, ASD, PDA are the most common acyanotic and TOF was the commonest cyanotic congenital heart defects respectively. Non-Invasive Cardiac diagnostic technique (like TTE) plays major in the diagnosis of CHD. When clinical evidences lead to suspicion of congenital heart defect, an echocardiography should be performed immediately.

Background: The aim of this study was to evaluate cardiac manifestations in HIV-infected children in India. Methods & Results: This was a cross sectional study in HIV positive children up to 18 years of age, at a pediatric HIV clinic of a tertiary care teaching hospital in Maharashtra, India. All children were thoroughly evaluated by detailed history, clinical examination and underwent chest radiograph, Electrocardiograph (ECG) and Echocardiography (Echo). Of the 119 children who completed the study, the male to female ratio was 1.16:1 and the mean age was 8.9 years (range 2-17 years). Cardiovascular abnormalities were detected in 74 (62%) children on echo and / or ECG. Echocardiography alone was abnormal in 44 (36.9%) children and ECG alone was abnormal in 56 (47%) children. However, only 11(9%) children were found to be symptomatic with cardiovascular symptoms. The prevalence of Congenital Heart Disease (CHD) was 4%. The most common ECG abnormality observed in the study was sinus tachycardia in 35 (29%) followed by ST-T changes in 20 (16.8%).The most common echocardiographic abnormality encountered was LV systolic dysfunction seen in 31 (26%) cases, followed by Low LV ejection fraction in 24 (20%) cases. Children with abnormal echo and ECG were in higher WHO clinical and immunological stages (III & IV), however the association between the two was not found to be statistically significant. Conclusions: This study establishes that subclinical cardiac manifestations are prevalent in HIV infected children. More research should be done on the clinical significance of these findings and the need for long-term follow up.

BACKGROUND & OBJECTIVES:Congenital heart diseases (CHDs) affect approx 6-8 infants per1000 live births have multifactorial origin. Various studies attribute number of maternal (e.g. family history of congenital heart diseases, consanguinity, febrile illness, co-morbidities like diabetes or hypertension) and fetal factors (prematurity, LBW, chromosomal abnormality) for development of CHDs. There is paucity of data in India; hence this study was conducted to evaluate risk factors in causation of CHDs in children. METHOD: It was a case control study conducted from Mar to Aug 2012 among children up to 10 years of age attending tertiary care hospital in Maharashtra, India. A total of 75 cases of CHDs and equal number of matched controls were included in the study. RESULTS: The mean age of cases was 19 months and that of controls 18 months. Male to female ratio was 1.5:1 among cases and 1.7:1 among controls. VSD was the commonest cardiac anomaly found in 37(49.33%) cases. In neonatal characteristics, cases had significantly increased number of prematurity and low birth weight as, compared to control(p=0.006), OR-3.25(95% CI 1. 35-8.25) and(p<0.001), OR-3.86 (95% CI 1.85-8.11) respectively. Twenty six (35%) children among cases were born of consanguineous marriage while 8(11%) in controls and association was found statistically significant [p<0.01, OR-4.44 (95% C.I=1.75-12.24)]. Similar associations were seen with family history of congenital heart diseases ), co-morbidities [p=0.02, OR-2.7 (95% CI 1.1-6.93)]. CONCLUSION: Our study showed maternal factors like consanguinity, family history of congenital heart diseases, co-morbidities like gestational diabetes, hypertension and drug intake during pregnancy were significant underlying risk factors for development of CHDs in children.